Pmsi Bally Medical Group

NPI #1588788996 in Bartp, Pennsylvania

Provider Information

NPI Number: 1588788996
Entity Type: Organization
Organization Name: Pmsi Bally Medical Group
Subpart: Yes (part of a larger organization)
Parent Organization: BALLY MEDICAL GROUP
Primary Specialty: Family Medicine
Enumeration Date: Mar 19, 2007
Last Updated: Jul 14, 2016

Practice Location

Address: 1315 ROUTE 100
City: Bartp
State: Pennsylvania
ZIP Code: 19504
Phone: (610) 845-2011

Authorized Official

Name: SHANA M ENOCHS
Title: CREDENTIALING SPECIALIST
Phone: (610) 327-4200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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